Adequate Margins to Prevent Local Re-recurrence of Rectal Cancer: Viewpoint of Pathological Findings
Komori, K.; Kimura, K.; Kinoshita, T.; Ito, S.; Abe, T.; Senda, Y.; Misawa, K.; Ito, Y.; Uemura, N.; Natsume, S.; Kawakami, J.; Iwata, Y.; Tsutsuyama, M.; Shigeyoshi, I.; Akazawa, T.; Hayashi, D.; Shimizu, Y.
Anticancer Research 35(12): 6747-6754
2015
ISSN/ISBN: 0250-7005 PMID: 26637891 Document Number: 681073
A sufficient surgical margin is critical for preventing re-recurrence and achieving R0 status after resection of a local recurrence of rectal cancer (LRRC). Re-recurrence-free survival was analyzed in 110 cases of LRRC according to histological type of primary lesion. The circumferential resection margin (CRM) was classified as 'R1' (x=0 μm), 'R0 shortness' (0 μm <x<2,000 μm), or 'R0 longness' (x≥2,000 μm). The histological change from the primary lesion to the recurrent lesion was classified as 'No change pattern', from well- to moderately-differentiated (W/M) to an expanding lesion; as 'Change pattern', from W/M to an infiltrating lesion. Re-recurrence-free survival was better in 'R0 longness' than 'R0 shortness' groups and showed that 'No change pattern' cases had considerably better prognosis than 'Change pattern' cases. Ensuring a CRM >2,000 μm during resection of LRRC is more likely to prevent re-recurrence. Cases with poorly differentiated carcinoma from the primary lesion to the recurrent lesion tend to have poor prognoses.